Phonophoresis and the Absorption of Dexamethasone in the Presence of an Occlusive Dressing

Article Critique

Phonophoresis and the absorption of dexamethasone in the presence of an occlusive dressing

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ARTICLE INFORMATION

Saliba S, Mistry DJ, Perrin DH, Gieck J, Weltman A. Phonophoresis and the absorption of dexamethasone in the presence of an occlusive dressing. J Athl Trai. 2007;42(3):349-354.

Objective:

Studies suggest that Phonophoresis provide a painless alternative for treatments of common inflammatory conditions, such as tendonitis, sprains, strains and bursitis; the authors examine the absorption and penetration of dexamethasone when occluded with a dressing and the application of ultrasound is applied.

Method:

Using blinding, the authors used ten healthy subjects in two separate 1-night studies with a 2-week lapse between treatments. The subjects were admitted to the general clinical research center where each had a therapeutic dosage of a topical dexamethasone mixture in an inert carbocol gel with an occlusive dressing applied for 30 minutes, then either the sham ultrasound (0.0 W/cm²) or ultrasound (1.0 W/cm²) was applied at 3-MHz for five minutes. Blood was extracted before each treatment and immediately after then 2, 4, 6, 8, and 10-hours to measure dexamethasone concentration in the serum.

Results:

The authors used a 2-way repeated-measures ANOVA indicating that the use of ultrasound showed greater concentrations of dexamethasone in blood serum over the 10-hour blood collections than the sham ultrasound, showing that a cumulative effect could occur if treatments were administered daily. Although the researchers intent was to determine the absorption of dexamethasone, further research is needed to evaluate the treatment effects and the ramifications of repeated exposure due to possible immunosuppressant effects.